Document Detail


The diagnostic and prognostic utility of positron emission tomography/computed tomography-based follow-up after radiotherapy for head and neck cancer.
MedLine Citation:
PMID:  19544537     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The detection of subclinical head and neck cancer recurrence or a second primary tumor may improve survival. In the current study, the authors investigated the clinical value of a follow-up program incorporating serial (18)F-fluorodeoxyglucose-positron emission tomography integrated with computed tomography (PET/CT) in the detection of recurrent disease in patients with head and neck cancer. METHODS: A total of 240 PET/CT scans were reviewed in 80 patients with head and neck cancer who were treated with radiotherapy (RT) from July, 2005 through August, 2007. All patients were followed with clinical examination, PET/CT, and correlative imaging for a minimum of 11 months (median follow-up, 21 months). RESULTS: The sensitivity, specificity, and positive and negative predictive values of PET/CT-based follow-up for detecting locoregional recurrence were 92%, 82%, 42%, and 98%, respectively. Corresponding values for distant metastases or second primary tumors were 93%, 96%, 81%, and 98%, respectively. Eight patients (10%) developed disease recurrences or second primary tumors that were amenable to salvage surgery with negative surgical margins. The 2-year progression-free survival and 2-year overall survival rates were significantly different between patients who had a negative and those with a positive PET/CT result within 6 months of the completion of RT (93% vs 30% [P<.001] and 100% vs 32% [P<.001], respectively). CONCLUSIONS: Although post-therapy follow-up using PET/CT is reportedly associated with a high false-positive rate in the irradiated head and neck, PET/CT appears to be a highly sensitive technique for the detection of recurrent disease. Furthermore, negative PET/CT results within 6 months of the completion of RT offer significant prognostic value.
Authors:
Johnny Kao; Ha Linh Vu; Eric M Genden; Bharat Mocherla; Eunice E Park; Stuart Packer; Peter M Som; Lale Kostakoglu
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Cancer     Volume:  115     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-23     Completed Date:  2009-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4586-94     Citation Subset:  AIM; IM    
Copyright Information:
2009 American Cancer Society.
Affiliation:
Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York, USA. johnny.kao@mountsinai.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Carcinoma, Squamous Cell / radiography*,  radionuclide imaging*,  radiotherapy
Female
Fluorodeoxyglucose F18 / diagnostic use
Follow-Up Studies
Head and Neck Neoplasms / radiography*,  radionuclide imaging*,  radiotherapy
Humans
Male
Middle Aged
Neoplasm Metastasis / radionuclide imaging
Neoplasm Recurrence, Local / radionuclide imaging
Neoplasms, Second Primary / radionuclide imaging
Positron-Emission Tomography*
Prognosis
Sensitivity and Specificity
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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